桂枝芍药知母汤加味治疗寒湿痹阻型膝骨性关节炎的临床疗效观察

发布时间：2018-03-01 22:23

本文关键词： 桂枝芍药知母汤寒湿痹阻膝骨性关节炎疗效观察　出处：《云南中医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过随机对照临床研究观察桂枝芍药知母汤加味治疗寒湿痹阻型膝骨性关节炎的疗效,为临床运用提供理论依据。方法:将符合纳入标准的门诊60例寒湿痹阻型膝骨性关节炎的病人,采用随机数字表法分组,病例数按治疗组:对照组=1:1进行设计。治疗组口服桂枝芍药知母汤加味,对照组口服塞来昔布胶囊,2周为1个疗程,连续治疗2个疗程。观察治疗前、治疗1个疗程后、治疗2个疗程后及治疗结束后3个月的膝骨性关节炎中医症候量表、症状分级量化评分表、WOMAC评分,统计并比较和分析两组治疗寒湿痹阻型膝骨性关节炎的临床疗效。结果:(1)桂枝芍药知母汤加味组和塞来昔布组均可以改善KOA患者的症状和体征,减轻疼痛,提高生活质量。(2)治疗结束时临床疗效比较:治疗组总有效率86.67%,对照组总有效率83.33%,两组疗效比较差异无统计学意义(p0.05),桂枝芍药知母汤加味与塞来昔布胶囊治疗寒湿痹阻型KOA可能疗效相当。(3)治疗1个疗程结束时,在患者临床症状评分上,两组都能不同程度地降低各评价量表及临床症状积分(p0.05),两组组间比较差异无统计学意义(p0.05),但从均数上分析,治疗1个疗程后,对照组改善情况优于治疗组。(4)治疗2个疗程结束时,与治疗前及治疗1个疗程比较,两组都能不同程度地降低患者各评价量表及临床症状积分(p0.05),提示桂枝芍药知母汤加味与塞来昔布对KOA均有疗效,且治疗组疗效较佳(p0.05,除疼痛外)。在疼痛评分上,组间比较无统计学差异(p0.05),治疗组在改善疼痛方面不优于对照组。(5)治疗结束后3个月结果:与治疗前比较,两组均能有效降低各量表及临床症状积分(p0.05);治疗组优于对照组(p0.05),提示桂枝芍药知母汤加味与塞来昔布对KOA均具有长期疗效,其中桂枝芍药知母汤加味治疗组的长期疗效可能更优。结论:桂枝芍药知母汤加味治疗寒湿痹阻型膝骨性关节炎有一定的近、远期临床疗效,能有效缓解患者的疼痛,减轻临床症状及体征。塞来昔布组较桂枝芍药知母汤加味组在疼痛治疗方面起效快,近期疗效更为明显;而长期疗效比较桂枝芍药知母汤加味组可能更为明显。
[Abstract]:Objective: to observe the therapeutic effect of Guizhi-paeoniao Anemarrhenia decoction on cold-dampness arthralgia type knee osteoarthritis by randomized controlled clinical study. Methods: 60 cases of cold and dampness arthralgia type knee osteoarthritis were divided into two groups by random digital table method. The number of cases in the treatment group was designed according to the control group (1: 1). The treatment group was treated with celecoxib capsule for 2 weeks, and the control group was treated with celecoxib capsule for 2 weeks. Before and after one course of treatment, the treatment group was treated with celecoxib capsule. TCM symptom scale of knee osteoarthritis after 2 courses of treatment and 3 months after treatment. The clinical efficacy of the two groups in the treatment of cold and dampness arthralgia type osteoarthritis of knee was compared and analyzed. Results both the decoction group and celecoxib group could improve the symptoms and signs of patients with KOA and relieve the pain. Comparison of clinical efficacy at the end of the treatment: the total effective rate of the treatment group was 86.67 and the total effective rate of the control group was 83.33. There was no significant difference between the two groups in the curative effect. There was no significant difference between the two groups in the treatment of cold dampness. At the end of one course of treatment, the effect of arthralgia type KOA may be equivalent. In the clinical symptom score of the patients, the two groups can reduce the evaluation scale and the clinical symptom score in varying degrees. The difference between the two groups is not statistically significant (p 0.05). However, after one course of treatment, there is no significant difference between the two groups in the clinical symptom score, but after one course of treatment, there is no significant difference between the two groups. The improvement of the control group was better than that of the treatment group. Both groups were able to reduce each evaluation scale and clinical symptom score of the patients in varying degrees (p0.05), indicating that both the decoction and celecoxib had curative effect on KOA, and the therapeutic effect in the treatment group was better than that in the control group (P 0.05), except for pain. There was no significant difference between the two groups (p0.05). The treatment group was not superior to the control group in improving pain. The treatment group was superior to the control group (P 0.05), which indicated that both the decoction and celecoxib had long-term curative effect on KOA, and the treatment group was superior to the control group (P 0.05), and the treatment group was superior to the control group (P 0.05), which indicated that both the decoction and celecoxib had long-term curative effect on KOA. Conclusion: Guizhi-paeoniao Anemarrhena decoction has a short-term and long-term clinical effect on the treatment of cold and dampness obstruction knee osteoarthritis, and can effectively relieve the pain of the patients. The clinical symptoms and signs were alleviated. Celecoxib group was more effective in pain treatment than Guizhi paeoniao Anemarrhena Anemarrhena decoction group, but the long-term effect was more obvious than Guizhi paeoniao Anemarrhena chinensis decoction group.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9

【参考文献】